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The not-so-great unwashed

The rat-catcher said there was no smell so bad as decaying rodent, but he's never smelled Copperfield's surgery on a wet Monday

Yes, I know I should be writing about the Major Issues Currently Facing General Practice. The fact that, for example, we should be recycling all available copies of the white paper into a massive papier-mache ball and rolling it down Whitehall to crush some politicians. Because otherwise, when the commissioning budgets bite and the public vents its spleen on us, those uncrushed individuals will be wetting their political pants with amusement.

Sod that, though. I want to write about patients who smell. You see, the other day, I had to see a man about a rat in my loft. The man turned up in a ‘discreet' van, only to emerge carrying so much kit that he might as well have marched up my street screaming, ‘Your neighbour's infested!'

After rat man had distributed enough warfarin to give my entire practice population melaena, he commented, ‘I hope it doesn't die indoors.' Why? Because, apparently, the odour of decaying rat is the single worst smell in the world.

Clearly he's never sniffed my waiting room on a wet Monday morning. There's something about the unwashed and nicotine-stained masses marinaded in rainwater that surely out-reeks dead rodent.

And this is the real-world-type issue we GPs face. We haven't the time to be navel gazing about commissioning when, at the coalface, the canaries are being asphyxiated by Eau d'Essex.

Not that our nasal skirmishes are limited to the great unwashed. Whoever coined the phrase, ‘The incredible potential of the consultation' missed out ‘stench' after ‘potential'. Some surgeries are parades of the putrid. I routinely waste precious minutes gagging, opening windows and ineffectually spraying air-freshener.

And I've not even mentioned the dreaded ‘lost tampon' scenario, partly for fear of being labelled a misogynist, but mainly because of appalling olfactory memories.

If you're reading, rat man, to get the full effect you need the Scratch'n'Sniff edition.

Under these circumstances, the only approach is to forget about confidentiality. Thus: ‘I'm sorry it honks like a farm, but there's been a toddler in here leaking rotavirus.' And: ‘I realise the room smells like a brewer's armpit – I'm not an alcoholic, but the previous patient is.'

The only whiffy punters I have any sympathy for are the mentally ill. Personal hygiene comes way down their priority list, after eating lightbulbs and stuffing rags in their keyholes to stop the CIA pumping in poisonous gas. Though if they did shower occasionally, maybe the poisonous gas would be less of an issue.

Anyway, what follows is the opposite of product placement. It's product requirement. Could someone, somewhere, send me an air freshener that actually works, so I can get on with my surgery without having to cordon off my room with biohazard tape? Failing that, send me a spray that looks like an air-freshener but is actually a neurotoxin, to squirt on the worst offenders. I realise our great leaders are busy working towards making our Brave New General Practice World smell rosy. So I'm relying on you, dear reader.

Now, about that dead rodent – anyone know the address of Richmond House?

Dr Tony Copperfield is a GP in Essex. You can email him at

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